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[Subacute effusive-constrictive pericarditis accompanied with miliary tuberculosis: a case report]

S Watanabe1, K Kariatsumari, Y Shimamoto

  • 1Second Department of Surgery, Kagoshima University, Faculty of Medicine, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|October 1, 1996
PubMed
Summary

Tuberculosis pericarditis mortality has decreased, but severe cases persist. A rare case highlights challenges in managing subacute effusive-constrictive pericarditis with miliary tuberculosis, even after surgery.

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Thoracic Surgery

Background:

  • Antimicrobial therapy significantly reduced tuberculosis pericarditis mortality.
  • Severe cases, including effusive-constrictive pericarditis, still present management challenges.
  • Miliary tuberculosis complicates pericarditis, requiring complex treatment strategies.

Observation:

  • A rare case of a 74-year-old male with subacute effusive-constrictive pericarditis and miliary tuberculosis was observed.
  • The patient initially improved after emergent pericardiectomy.
  • Recurrent cardiac failure occurred due to tuberculous fibrous epicarditis.

Findings:

  • Early pericardiectomy provided temporary relief but did not prevent long-term complications.
  • Fibrous epicarditis from tuberculous inflammation led to recurrent cardiac failure.

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  • The case underscores the complexity of managing severe tuberculosis pericarditis.

    • Implications:

    • Optimal surgical timing and indications for pericardiectomy in such cases require further investigation.
    • The role of corticosteroids in conjunction with antitubercotic drugs needs clarification.
    • This case highlights the need for comprehensive management strategies for refractory tuberculosis pericarditis.